厄洛替尼与培美曲塞在非小细胞肺癌维持治疗中的疗效比较

Efficacy Comparison of Pemetrexed or Erlotinib for in the Maintenance Therapy of Advanced Non-small Cell Lung Cancer

目的比较观察厄洛替尼与培美曲塞在晚期非小细胞肺癌(NSCLC)维持治疗中的疗效及毒副反应。方法纳入72例晚期NSCLC患者,一线治疗均给予含铂双药标准一线方案化疗,能顺利完成4周期化疗且病情得到控制者共42例,然后随机均分为2组,分别给予厄洛替尼及培美曲塞维持治疗,比较观察2组的生存情况和毒副反应。结果厄洛替尼组、培美曲塞组的中位无进展生存时间分别为5.8个月、5.5个月,差异无统计学意义(P>0.05)。厄洛替尼组主要毒副反应为皮疹和腹泻,培美曲塞组主要毒副反应为消化道反应和血液学毒性,2组骨髓抑制、恶心呕吐、皮疹发生率比较差异有统计学意义(P<0.05)。结论厄洛替尼与培美曲塞作为维持治疗方法治疗晚期NSCLC在延长生存期方面作用相似,但厄洛替尼的毒副反应更轻,患者更易于耐受。

Objective To compare the efficacy and toxicities between erlotinib and pemetrexed for in the mainte- nance therapy of advanced non-small cell lung cancer （ NSCLC ）. Methods Seventy-two patients with advanced NSCLC were treated with platinum-based double standard regimen as the first-line drug regimen. 42 patients with disease control after 4 cycles of chemotherapy, was divided into two groups, were given erlotinib and pemetrexed for maintenance therapy separately,the survival and toxicities of the two groups were compared. Results The median progression-free survival time of the erlotinib group was 5.8 months, and was 5.5 months of the pemetrexed group （ P 〉 0.05 ）. The major toxicities of erlotinib were rash and diarrhea, those of pemetrexed were gastrointestinal reac- tion and baematological toxicities,there were statistically significant differences in the incidence of marrow depres- sion, nausea and vomiting, rash showed between the two groups （ P 〈 0.05 ）. Conclusion The survival of erlotinib and pemetrexed is similar in the maintenance treatment of advanced NSCLC, but the toxicities of erlotinib are milder than pemetrexed.